半夏白术天麻汤治疗眩晕高血压病举隅

高血压病是我国发病率较高的疾病之一,西医治疗以长期服用降压药物为主要治疗方式,但常因依从性差的原因导致血压控制不佳,而用中医辨证治疗对于首次发现高血压的患者,可明显有效地降低高血压的发病率。高血压病在中医学中属"眩晕",在临床中常常会用半夏白术天麻汤来治疗眩晕,本文通过跟师医案及临床收集介绍半夏白术天麻汤治疗高血压眩晕临证方药的运用。     

不同规格怀牛膝不同极性部位HPLC指纹图谱

目的研究并比较不同规格怀牛膝不同极性部位的HPLC指纹图谱,探索其内部质量差异,为该药材的规格标准完善及临床用药提供参考。方法将怀牛膝用体积分数75%乙醇水浴回流提取,得体积分数75%乙醇回流提取物,用40 mL水溶解后,依次用石油醚、三氯甲烷、乙酸乙酯、正丁醇进行萃取,得到各萃取相及萃取后的水相,浓缩至浸膏,采集各部位HPLC指纹图谱;运用相似度、综合聚类法进行数据分析,同时对其不同部位的指纹图谱进行比对分析。结果石油醚、氯仿部位均标定了11个共有峰,乙酸乙酯部位标定了10个共有峰,正丁醇部位标定了19个共有峰,水部位标定8个共有峰;氯仿部位指纹图谱相似度差异较大,其他部位指纹图谱相似度差异较小,均在0.9以上;石油醚部位指纹图谱差异主要体现在峰高,乙酸乙酯部位、氯仿部位、水部位的化学成分种类及峰高均存在差异;综合聚类分析能将不同规格怀牛膝区分开。结论不同规格怀牛膝内部质量存在差异;实验中所建立的HPLC指纹图谱可以全面反映不同规格怀牛膝的化学成分分布,为不同规格怀牛膝的整体质量评价提供参考。     

Inactivated influenza vaccine formulated with single-stranded RNA-based adjuvant confers mucosal immunity and cross-protection against influenza virus infection

Influenza vaccination is considered the most valuable means to prevent and control seasonal influenza infections, which causes various clinical symptoms, ranging from mild cough and fever to even death. Among various influenza vaccine types, the inactivated subunit type is known to provide improved safety with reduced reactogenicity. However, there are some drawbacks associated with inactivated subunit type vaccines, with the main ones being its low immunogenicity and the induction of Th2-biased immune responses. In this study, we investigated the role of a single-stranded RNA (ssRNA) derived from the intergenic region in the internal ribosome entry site of the Cricket paralysis virus as an adjuvant rather than the universal vaccine for a seasonal inactivated subunit influenza vaccine. The ssRNA adjuvant stimulated not only well-balanced cellular (indicated by IgG2a, IFN-γ, IL-2, and TNF-α) and humoral (indicated by IgG1 and IL-4) immune responses but also a mucosal immune response (indicated by IgA), a key protector against respiratory virus infections. It also increases the HI titer, the surrogate marker of influenza vaccine efficacy. Furthermore, ssRNA adjuvant confers cross-protective immune responses against heterologous influenza virus infection while promoting enhanced viral clearance. Moreover, ssRNA adjuvant increases the number of memory CD4⁺ and CD8⁺ T cells, which can be expected to induce long-term immune responses. Therefore, this ssRNA-adjuvanted seasonal inactivated subunit influenza vaccine might be the best influenza vaccine generating robust humoral and cellular immune responses and conferring cross-protective and long-term immunity.     

复方金银花擦剂中没食子酸的含量测定

目的：建立测定复方金银花擦剂中没食子酸的含量测定方法。方法：Novapak C18色谱柱，流动相甲醇冰醋酸-二甲基酰胺-水（2：0．5：20：90），检测波长275nm。结果：该法线性关系良好，相关系数r=0．9996，加样回收率为99．02％，RSD=1．94％。结论：该方法操作简单，分离效果好，可用于复方金银花擦剂的质量控制。     

核苷酸结合寡聚化结构域样受体蛋白3炎症小体在脑卒中后认知障碍中的研究进展

脑卒中后认知障碍(PSCI)是脑卒中患者常见的并发症,严重影响患者的生活质量。目前,PSCI在临床治疗中尚未发现有效的针对性治疗措施。大量研究证实核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)炎症小体的活化在PSCI中起关键作用,且对其进行的许多抑制性治疗显示出了改善认知障碍的功效。为此,本文总结了NLRP3炎症小体的活化和影响因素及其与PSCI的关系,发现在PSCI的细胞和动物模型中,针对NLRP3或其炎症小体成分的抑制措施可以减轻炎性反应和相应的病理特征,从而促进其认知功能的恢复,因此,靶向NLRP3炎症小体可能是PSCI治疗的新趋势。然而到目前为止,尽管许多药物和治疗措施已成功鉴定出能够抑制NLRP3炎症小体的活化,但其在临床中的治疗效果和安全性仍有待进一步验证。     

Hydranencephaly in CENPJ-related Seckel syndrome

Pathogenic variants in CENPJ have been first identified in consanguineous Pakistani families with Hereditary Primary Microcephaly type 6 (MCPH6). In addition to primary microcephaly, the CENPJ-related phenotypic spectrum lately included also distinctive and peculiar ‘bird-like’ craniofacial dysmorphisms, intrauterine and/or postnatal growth retardation, and moderate to severe intellectual disability (ID). These features are also part of the clinical spectrum of Seckel syndrome (SCKL) a genetically heterogeneous neurodevelopmental condition caused by mutations in different genes involved in cell cycle progression. Among these, CENPJ is responsible for type 4 Seckel syndrome (SCKL4). The literature reports two individuals affected by SCKL4 suffering from seizures and other two individuals with other brain malformations in addition to microcephaly. However, neither epilepsy nor brain malformations are described in detail and genotype-phenotype information remains limited. We describe the first Caucasian affected with SCKL4 and harboring a novel, homozygous mutation in CENPJ. We detail the clinical and neuroradiological findings including structural focal epilepsy and a severe brain malformation (i.e., hydranencephaly) that was never associated with SCKL4 to date.     

仿生双动全髋关节置换术治疗强直性脊柱炎累及髋关节病变的疗效观察

目的观察仿生双动全髋关节置换术治疗强直性脊柱炎累及髋关节病变的临床疗效,并探讨双动臼杯在脊柱僵硬患者中应用的优势。方法回顾性分析河南省洛阳正骨医院2017年2月至2019年3月行双动全髋关节置换术的21例(41髋)强直性脊柱炎患者的临床资料,其中男18例,女3例。临床随访根据X线检查、Harris评分系统及手术前后髋关节总活动度进行评价。结果21例(41髋)患者均得到随访,随访时间13~38个月,中位数为25个月,平均(25.47±6.59)个月。Harris评分由术前(40.80±10.35)分增加到术后末次随访的(87.41±10.18)分,髋关节总活动度由术前(51.87±15.71)°增加到术后的(198.53±18.83)°,差异均具有统计学意义(P<0.05)。X线检查显示所有髋关节假体位置良好,2例(3髋)出现异位骨化,所有患者均未出现关节脱位、假体松动、感染。结论双动全髋关节置换术治疗强直性脊柱炎累及髋关节病变可明显改善髋关节功能,减轻疼痛,双动臼杯高稳定性的特点,降低了 AS患者髋臼假体安放的手术技术要求,容错率较高,从而最小化脱位的风险。     

Penetration moxibustion for postpartum subinvolution of uterus: Two case reports and mechanism analysis: 透灸法成功治疗产后子宫复旧不良:两则病例报告及机制分析

This article introduced the application of penetration moxibustion in successfully treating two cases of postpartum subinvolution of uterus. The main complaint of one case was increasing volume of abnormal vaginal bleeding for five days after delivery. The bleeding stopped after the patient received 7 times treatment of warming needle and penetration moxibustion on Zhōngjí (中极CV3), Guānyuán (关元CV4) and Qìhăi (气海CV6). The other case complained about persistent abdominal pain for 15 days, which was worsening for the recent 2 days. The symptom of abdominal pain was relieved after the penetration moxibustion was applied on CV4, CV6 and Zǐgōng (子宫 EX-CA1) for 5 times for the case. Penetration moxibustion can relieve abdominal pain during the postpartum period, accelerate lochia discharge, and recovery of menstrual and uterine cavity. Àiyè (艾叶 Artemisiae Argyi Folium) was proved to have antibacterial, hemostatic, and analgesic effects. The warming function and radiation features of moxibustion can help to alleviate spasm of the smooth muscle in the uterus and enhance the metabolism of the uterine tissue by expanding microvessels and improving the circulations of both blood and lymph. It can also activate cells in the uterine tissue by increased temperature in order to enhance the decomposition and elimination of pathological wastes, such as inflammation and hematoma. In addition, it can also relieve pelvic pain by inhibiting neuronal excitability.     

中医穴位贴敷结合孟鲁司特钠治疗支气管哮喘患儿临床疗效

目的：分析中医穴位贴敷结合孟鲁司特钠治疗支气管哮喘患儿的临床效果。方法：选取河南省中医院2019年8月至2022年2月收治的90例支气管哮喘患儿,采用信封法分为对照组和观察组,各45例。对照组患儿采取孟鲁司特钠治疗,观察组患儿在对照组上联合中医穴位贴敷,比较两组患儿治疗效果。结果：治疗后观察组患儿用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、呼气峰值流速（PEF）均高于对照组,差异具有统计学意义（P <0.05）;治疗后观察组患儿血清肿瘤坏死因子–α(TNF–α)、免疫球蛋白E(IgE)、降钙素原（PCT）水平均低于对照组,差异具有统计学意义（P <0.05）;治疗后观察组患儿日间及夜间哮喘症状评分均低于对照组,差异具有统计学意义（P <0.05）。结论：对支气管哮喘患儿采取中医穴位贴敷结合孟鲁司特钠可有效提高疗效,显著改善哮喘症状,改善血清学指标。     

茯苓对阴虚水肿模型大鼠及其热象的影响

目的 观察茯苓对阴虚水肿模型大鼠的影响,研究茯苓利水作用特点及机制,并评价茯苓对阴虚水肿所表现出热象的影响。方法 尾iv阿霉素联合ig甲状腺片复制阴虚水肿模型大鼠,给予茯苓水煎液或六味地黄丸干预4周,观察大鼠水肿情况和一般生长状态,检测24 h尿量和尿蛋白,测量肛温,进行冷热板实验计算热板停留时间比;检测血清总蛋白（total cholesterol,TP）、白蛋白（albumin,Alb）、尿素氮（blood urea nitrogen,BUN）、肌酐（creatinine,Cr）、环磷酸腺苷（cyclic adenosine monophosphate,c AMP）、环磷酸鸟苷（cyclic guanosine monophosphate,c GMP）水平;测定肾组织超氧化物歧化酶（superoxide dismutase,SOD）活性及活性氧（reactive oxygen species,ROS）、丙二醛（malondialdehyde,MDA）水平;苏木素-伊红（HE）染色观察肾组织病理变化;Western blotting检测肾脏组织Klotho和棕色脂肪组织中解偶联蛋白1...